Доктор ахборотномаси № 4—2019
135
УДК: 616.31–002.157/.2
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036+616.6:616.9
LOCAL IMMUNITY FACTORS IN PATIENTS
WITH CHRONIC RECURRENT APHTHOUS STOMATITIS
N. N. Khabibova, S. F. Suleymanov
Bukhara state medical institute, Bukhara, Uzbekistan
Key words:
chronic, aphthous stomatitis, oral liquid, local immunity, lysozyme, immunoglobulins.
Таянч сўзлар:
сурункали, афтоз стоматит, оғиз суюқлиги, маҳаллий иммунитет, лизоцим,
иммуноглобулинлар.
Ключевые слова:
хронический, афтозный стоматит, ротовая жидкость, местный иммунитет, лизоцим, имму-
ноглобулины.
The article investigated the condition of local immunity in the oral cavity in 48 patients with chronic recurrent
aphthous stomatitis (CRAS). Patients with CRAS showed a decrease in the level of lysozyme and sIgA in the oral
liquid (OL), which is an unfavorable prognostic criterion in patients with CRAS. This undoubtedly affects the course
of the pathology in patients with CRAS. Low values of lysozyme and sIgA can lead to impaired microbiocenotic sta-
tus and reduced functioning of the oral mucosa (OM) in patients with CRAS.
СУРУНКАЛИ ҚАЙТАЛУВЧИ АФТОЗ СТОМАТИТ БИЛАН
КАСАЛЛАНГАН БЕМОРЛАРДА МАҲАЛЛИЙ ИММУНИТЕТ ОМИЛЛАРИ
Н. Н. Хабибова, С. Ф. Сулейманов
Мақола сурункали қайталувчи афтоз стоматит (СҚАС) билан касалланган 48 беморда оғиз бўшлиғида
маҳаллий иммунитет ҳолати ўрганилди. СҚАС билан касалланган беморлада лизоцим ва sIgA нинг оғиз
суюқлигида (ОС) пасайиши аниқланди, бу СҚАС билан касалланган беморлада салбий прогностик мезонидир.
Бу шубҳасиз, СҚАС билан касалланган беморларда патология кечишида таъсир қилади. Лизоцим ва sIgA нинг
паст кўрсатгичлари СҚАС да биоценотик ҳолатнинг бузилишига ва оғиз бўшлиғидаги шиллиқ қаватининг
ишлашини пасайишига олиб келиши мумкин.
МЕСТНЫЕ ФАКТОРЫ ИММУНИТЕТА У БОЛЬНЫХ
С ХРОНИЧЕСКИМ РЕЦИДИВИРУЮЩИМ АФТОЗНЫМ СТОМАТИТОМ
Н. Н. Хабибова, С. Ф. Сулейманов
Бухарский государственный медицинский институт, Бухара, Узбекистан
В статье исследовали состояние местного иммунитета в ротовой полости у 48 больных с хроническим
рецидивирующим афтозным стоматитом (ХРАС). У больных с ХРАС выявили снижение уровня лизоцима и
sIgA в ротовой жидкости (РЖ), что является неблагоприятным прогностическим критерием у больных с
ХРАС. Это, несомненно, влияет на течение патологии у больных с ХРАС. Низкие значения лизоцима и sIgA
могут привести к нарушениям микробиоценотического статуса и снижению функционирования слизистой
оболочки полости рта (СОПР) у больных с ХРАС.
N. N. Khabibova, S. F. Suleymanov
Considerable attention is paid to the problem of prevention and treatment of chronic diseases
(CD) of the oral mucosa (OM) due to an increase in the negative impact on the human div of en-
vironmental factors, a wide and not always justified use of medicines with antibacterial properties.
CRAS is considered to be one of the most frequent diseases of the oral
mucosa. A significant role
in the pathogenesis of chronic inflammatory processes is assigned to the microbiocenotic status of
OM [1–3].
Purpose of the study: to study the local immunity factors in the oral cavity (OC) in patients
with CRAS.
Material and methods.
During the period from 2016 to 2018, 48 patients with CRAS aged
from 21 to 46 years old were examined at the Department of Therapeutic Dentistry of the Bukhara
State Medical Institute. At the same time, clinical symptoms of CRAS, allergological and laborato-
ry examinations were taken into account.
The control group consisted of 14 somatically healthy individuals with intact periodontal age
from 20 to 39 years.
The concentration of lysozyme in the oral liquid (OL) of the OC was investigated by diffu-
sion in an agar gel. The concentration of immunoglobulin classes slgA, IgA and IgM was studied
Доктор ахборотномаси № 4—2019
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Оригинальная статья
on a Cobas
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411 Immunoassay Analyzer (Roche, Switzerland), using the sets from the same com-
pany. The research results are processed using Student criterion.
Results and discussion.
In patients with CRAS on the surface of aphthae, ulcers an extreme-
ly diverse micro flora is defined, including representatives of almost all types of microorganisms.
Basically microorganisms were represented by 2 groups: microaerophilic Streptococcus and obli-
gate anaerobes, facultative anaerobes.
On the surface, aphthae in the majority (56%) were coccal flora, much of which (44%) was
accounted for by strict anaerobes (Peptostreptococcus, Peptococcus). At the same time, Bacteroids
accounted for 15%, Actinomycetes
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13%, Leptotrichia and Clostridia 4% each.
Patients with CRAS showed a significant decrease in lysozyme level in the OL (Table 1).
Groups
Quantity of patients
Lysozyme
(mkg/ml)
Healthy individuals
14
198,76 ± 9,58
Patients with CRAS
48
113,24 ± 8,67*
Note: *
-
significance of differences at p<0.05 and above.
Table 1.
The content of lysozyme in patients with OL of patients with CRAS.
The parameters of humoral immunity in the OL in patients with CRAS are presented in ta-
ble. 2. It is known that sIgA, which is part of the OL and saliva, plays an important role in local
immunity. In addition, the composition of saliva in small quantities contains Ig classes A and G
[5].
Patients with CRAS have a lower sIgA content in the OL, in contrast to the control. Signifi-
cant deficiency in the content of sIgA in patients with CRAS in OL reflected on the production
spectrum of two other Ig: IgA and IgG (Table 2). Their levels were higher than similar values of
the control group.
Apparently, a low level of sIgA, which is more responsible for local immunity, can lead to
impaired microbiocenosis and impaired functioning of the
OM, which may well be one of the un-
favorable factors leading to the development of CRAS in patients [4, 5].
Groups
The amount of sIgA
mg/ml
The amount of sIgA
mg/ml
The amount of sIgA
mg/ml
Healthy individuals,
n = 14
43,78 ± 3,07
103,70 ± 2,55*
48,24 ± 4,61
Patients with chronic re-
current aphthous stomatitis
24,54 ± 1,98*
148,12 ± 9,43*
72,31 ± 5,03*
Note: *
-
significance of differences at p <0.05 and above.
Table 2.
The content of immunoglobulins in the OL in patients with CRAS.
The obtained results indicate that the prescription of CRAS can affect the secretory level and
serum Ig entering the OL and thereby aggravate the degree of the disease, as indicated by the peri-
odic exacerbations of the inflammatory process in the OM [4, 5].
Thus, in patients with CRAS, a decrease in the parameters of local immunity was revealed,
exactly, the amount of lysozyme and sIgA in OL. This undoubtedly affects the course of the pa-
thology in patients with CRAS. In the future, we plan to conduct immune corrective therapy in or-
der to eliminate the identified violations of the parameters of local immune reactivity and improve
the condition of patients with CRAS.
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N. N. Khabibova, S. F. Suleymanov
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